Wednesday, March 16, 2011


I have been thinking for a few months that Sweets may potty train pretty soon. She signs CHANGE when she wants you to change her diaper, or will even go fetch a clean diaper and bring it to you. She also signs DIAPER and POTTY. She has been going for long stretches between wet diapers, and even wakes up dry from nights and naps more and more fequently. Munchkin potty trained right around this age too - she was in unders full-time during the day the week of her 2nd birthday. Sweets will turn two in 6 weeks.

When I first mentioned to my husband that I thought Sweets might be ready to potty train soon, he was pretty skeptical. He said "She's late doing everything else, I don't know what makes you think she's going to potty train." I just took the baby potty out from storage and showed it to her. Some time later, we were talking about Sweets' delays, and my husband said that he feared that we would start to expect less from her, and that she would therefore do less. I said, you mean like potty training? After that he was 100% supportive of potty training!

So I brought the baby potty into the living room and we have been leaving her naked from the waist down at home more often. She has been sitting on the potty at diaper changes, but she hasn't "done" anything in it yet. That is up until last night!

She was in the bath and started signing POTTY and frantically making noises - "Mmmmh! Mmmmh!" I didn't want her to potty in the bath, so I took her out and dried her off and sat her on the potty. She sat, but didn't go. When she stood up, she held her knees together and grabbed her crotch and made the frantic "Mmmmh! Mmmmh!" noises again. Then she sat and stood up and repeated the noises. This cycle went on for about 20 minutes interspersed with some playing. It was like she knew she had to go, but she didn't really know what to do about it and was trying to hold it in. Eventually, she got so frantic that I sat her on the potty and played "If You're Happy And You Know It" with her to occupy her hands and try to keep her still. And when she got up, there was a big poop in the potty!

We worry about her cognitive abilities, because she still doesn't succeed at the shape sorter or simple puzzles. But she can communicate many things through signing, which shows us that she understands language and remembers the signs and knows how to use them. So maybe she will be able to potty train just fine, despite her other delays!

Monday, March 14, 2011

orthotics and more, updates

We just had another PT eval and Sweets tested at 20 months for Stationary (37%), 17 months for Locomotion (5%) and 18 months for Manipulation (16%). Her overall gross motor is 10%. Her PT said that she thinks that the type of test that was used judges her more harshly than where she really is though.

Her balance is quite poor though, and she falls frequently. The PT has recommended that we have her fit for orthotics for her feet because she pronates when she walks - turns her feet to the edge, which affects her balance. The orthotics would fit in her shoe and would prevent her from rolling her feet. The PT thinks that we will probably get Sure Steps, but the orthotist will make the final call as to what kind would be best.

Sweets also had an OT eval last week because our coordinator saw that she wasn't able to do the shape sorter when she observed a recent developmental therapy session. In the OT eval, Sweets was able to pick up pennies off the floor just fine and put them in the slot in a piggy bank with either hand. The assessment showed that her problem is not really with her fine motor skills as much as with her cognitive skills. She doesn't perform the shape sorter or puzzle well because she doesn't know where the object should go, not because her hands can't manipulate it properly. So, she doesn't need OT therapy, and will just continue with the developmental therapy with a new goal of working on problem solving toys and helping her persist to her level of abilities without giving up.

Our speech visits are going up from two 30-minute sessions per week to two 45-minute sessions. It costs us the same either way, so that's nice.

We have been dealing with a conflict regarding the billing for the therapies. We started 9 months ago and this is the first time we've gotten a bill for anything, and we really had to harrass them for it. But when I got it, it was not the amount that I expected, it was about double. I called them up and told them they did my bill wrong, and they said that I was the one who was wrong. Both therapy agencies did it the same way, so I was thinking that they must be right and I've been wrong this whole time about how much this was going to cost us. I complained to my early intervention coordinator and after 2 weeks they got back to me and told me I was right and the agencies were wrong and they were going to make sure they fixed it for me. So that is nice. I wonder how many people they are messing up the bills on that don't even realize. They were basically double billing my insurance and the state for the same amount, so that they were collecting about 1.5 times what they should.

We are going to run out of insurance-covered therapy visits. We only get 75 per year (increased over 50 last year because we upped our insurance option) and we are using 3 per week now. She actually gets 4 per week - 2 speech, 1 PT, 1 developmental - but the developmental is free for us. So we are going to go off the insurance for a while and just pay out of pocket so that we don't use up all of our visits right away. Right now we are still on a 40% sliding scale rate, but we think that will go up next time they re-evaluate us in June, so we figure we should pay the out-of-pocket now rather than later.

We are still looking into the developmental preschool for her, but we are finding that their therapists aren't on our insurance, so that is a complication. They say that we CAN use our own therapists, but they really think it's better if we use theirs.